NPI | 1598715369 |
---|---|
Entity Type | Organization |
Authorized Contact | LOU ANN NEWBY Registered Nurse 608-635-4923 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: WI 126237030) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2020-08-22 |